PEDIATRIC NURSING TEST BANK | 2026
| NCLEX-STYLE MCQS & CLINICAL
JUDGMENT QUESTIONS
Question 1
Category: Growth and Development Across Infancy, Childhood,
and Adolescence
NCLEX Client Needs Category: Health Promotion and
Maintenance
CJMM Clinical Judgment Step: Recognizing Cues
Clinical Scenario
A 6-month-old infant is brought to the pediatric clinic by the
mother for a well-child checkup. The nurse reviews the infant's
birth history and current physical assessment data.
• Birth History: Full-term, birth weight 3.4 kg (7.5 lb), head
circumference 35 cm.
• Current Assessment: Weight 6.8 kg (15 lb), head
circumference 43 cm. Posterior fontanelle is closed.
, Anterior fontanelle is soft and flat. Infant rolls from back to
front, transfers a toy from one hand to the other, and
babbles with consonant sounds ("ba-ba"). Infant displays
pincer grasp using the thumb and index finger.
Question Prompt
Which assessment finding requires further clinical investigation
by the nurse?
Options
• A. Rolling from back to front
• B. Displaying a fine pincer grasp
• C. Closure of the posterior fontanelle
• D. Doubling of birth weight
Correct Answer
B. Displaying a fine pincer grasp
Comprehensive Rationale
Why the Correct Answer is Correct
A fine pincer grasp (using the index finger and thumb to pick up
small objects) is a motor skill that typically develops between
10 to 12 months of age. At 6 months, an infant is expected to
demonstrate a palmar grasp (using the whole hand to grasp
objects) and begin transferring objects from hand to hand.
,In clinical evaluation, displaying a advanced motor skill
prematurely may indicate asymmetrical muscle tone, spasticity
(e.g., hypertonicity associated with cerebral palsy), or
persistent primitive reflexes (such as an unintegrated grasp
reflex) forcing hand positioning. The nurse must recognize this
cue as an unexpected finding for a 6-month-old infant and
investigate further.
Why the Other Options are Incorrect
• A. Rolling from back to front: Rolling from front to back
typically occurs at 4 to 5 months, and rolling from back to
front occurs around 6 months. This is a normal gross
motor landmark.
• C. Closure of the posterior fontanelle: The posterior
fontanelle normally closes by 2 to 3 months of age. An
open posterior fontanelle at 6 months would be abnormal.
• D. Doubling of birth weight: An infant's birth weight
typically doubles by 5 to 6 months of age and triples by 12
months. An increase from 3.4 kg to 6.8 kg represents an
exact doubling, which is an expected growth pattern.
NCLEX Pediatric Nursing Pearl
Anterior fontanelles close between 12 and 18 months, whereas
posterior fontanelles close by 2 to 3 months; developmental
, motor skills must be evaluated strictly against age-appropriate
benchmarks to identify neuromuscular abnormalities early.
Question 2
Category: Growth and Development Across Infancy, Childhood,
and Adolescence
NCLEX Client Needs Category: Physiological Integrity
CJMM Clinical Judgment Step: Analyzing Cues
Clinical Scenario
A 4-year-old child with a history of asthma is hospitalized for
acute respiratory distress. During the physical examination, the
nurse attempts to place an oxygen saturation monitor on the
child's finger and perform a chest examination. The child pulls
away, hides behind the parent, cries loudly, and shouts, "Don't
hurt me, I'll be good!"
Question Prompt
How should the nurse analyze the child's reaction based on
developmental stage concepts?
Options
• A. The child is demonstrating normal preschool separation
anxiety and stranger fear.
| NCLEX-STYLE MCQS & CLINICAL
JUDGMENT QUESTIONS
Question 1
Category: Growth and Development Across Infancy, Childhood,
and Adolescence
NCLEX Client Needs Category: Health Promotion and
Maintenance
CJMM Clinical Judgment Step: Recognizing Cues
Clinical Scenario
A 6-month-old infant is brought to the pediatric clinic by the
mother for a well-child checkup. The nurse reviews the infant's
birth history and current physical assessment data.
• Birth History: Full-term, birth weight 3.4 kg (7.5 lb), head
circumference 35 cm.
• Current Assessment: Weight 6.8 kg (15 lb), head
circumference 43 cm. Posterior fontanelle is closed.
, Anterior fontanelle is soft and flat. Infant rolls from back to
front, transfers a toy from one hand to the other, and
babbles with consonant sounds ("ba-ba"). Infant displays
pincer grasp using the thumb and index finger.
Question Prompt
Which assessment finding requires further clinical investigation
by the nurse?
Options
• A. Rolling from back to front
• B. Displaying a fine pincer grasp
• C. Closure of the posterior fontanelle
• D. Doubling of birth weight
Correct Answer
B. Displaying a fine pincer grasp
Comprehensive Rationale
Why the Correct Answer is Correct
A fine pincer grasp (using the index finger and thumb to pick up
small objects) is a motor skill that typically develops between
10 to 12 months of age. At 6 months, an infant is expected to
demonstrate a palmar grasp (using the whole hand to grasp
objects) and begin transferring objects from hand to hand.
,In clinical evaluation, displaying a advanced motor skill
prematurely may indicate asymmetrical muscle tone, spasticity
(e.g., hypertonicity associated with cerebral palsy), or
persistent primitive reflexes (such as an unintegrated grasp
reflex) forcing hand positioning. The nurse must recognize this
cue as an unexpected finding for a 6-month-old infant and
investigate further.
Why the Other Options are Incorrect
• A. Rolling from back to front: Rolling from front to back
typically occurs at 4 to 5 months, and rolling from back to
front occurs around 6 months. This is a normal gross
motor landmark.
• C. Closure of the posterior fontanelle: The posterior
fontanelle normally closes by 2 to 3 months of age. An
open posterior fontanelle at 6 months would be abnormal.
• D. Doubling of birth weight: An infant's birth weight
typically doubles by 5 to 6 months of age and triples by 12
months. An increase from 3.4 kg to 6.8 kg represents an
exact doubling, which is an expected growth pattern.
NCLEX Pediatric Nursing Pearl
Anterior fontanelles close between 12 and 18 months, whereas
posterior fontanelles close by 2 to 3 months; developmental
, motor skills must be evaluated strictly against age-appropriate
benchmarks to identify neuromuscular abnormalities early.
Question 2
Category: Growth and Development Across Infancy, Childhood,
and Adolescence
NCLEX Client Needs Category: Physiological Integrity
CJMM Clinical Judgment Step: Analyzing Cues
Clinical Scenario
A 4-year-old child with a history of asthma is hospitalized for
acute respiratory distress. During the physical examination, the
nurse attempts to place an oxygen saturation monitor on the
child's finger and perform a chest examination. The child pulls
away, hides behind the parent, cries loudly, and shouts, "Don't
hurt me, I'll be good!"
Question Prompt
How should the nurse analyze the child's reaction based on
developmental stage concepts?
Options
• A. The child is demonstrating normal preschool separation
anxiety and stranger fear.
